20150266 Permit Pkg 08122015City of Yelm
Community Development Department
Building Division
Phone: (360) 458 -8407
Fax: (360) 458 -3144
Applicant:
Name: JIMMY /LESLIE MOXLEY
Address: 9877 DOTSON ST SE
YELM WA 98597
Property Information:
Site Address: 9877 n0TSnN ST SF
Permit No.: 20150266
Issue Date: 8/12/2015
(Work must be completed within 180 days)
Phone: 808 - 349 -7373
Owner: JIMMY MOXLEY
Assessor Parcel No.: 78640107400 Subdivision: TAHOMA TERRA Lot: 74
Contractor Information:
Name: SUNSET AIR INC
Address: TERRY MEDLOCK
5210 LACEY BLVD.
LACEY WA 98503
Contractor License No.: 10734 Expires
Phone:
12/31/2015
Project Information:
Project: MECHANICAL
Description of Work:
ADD AIR CONDITIONER. DUCT TEST REQUIRED.
Sq. Ft. per floor:
Heat Type (Electric, Gas, Other):
First
Second
Third
Garage
Basement
Fees:
Item
MECHANICAL
Contractor
SUNSET AIR INC
TOTAL FEES:
Applicant's Affidavit:
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including th a governing zoning and land subdivision, and in addition, all covenants,
easements and restric f tecord. If applying as a contractor, I further certify that I am currently
registered in the Sta of �ihington. If
Date
f / /5
Firm 5uf?5eT zp
Fees
$ 29.50
$ 29.50
OFFICIAL USE ONLY
# Sets of Prints:
Final Inspection:
Date:
By:
City of Ni
(36 ) 458 -3244
REC #: 00203972 8/12/2015 12:51 PM
OPER: CO TERM: 001
REF #: 35005
PAID BY:
IRAN: 33,0000 BUILDING PERMITS
20150265 29.50CR
DAVIS, JASON & MICHELL
9337 PRAIRIE WIND ST SE
MECH 29,50CR
TRAN: 33.0000 BUILDING PERMITS
20150270 29.50CR
STANTON, BETTY J.
14905 PRAIRIE VISTA LP SE
MECH 29,50CR
TRAN: 33,0000 BUILDING PERMITS
20150266 29.50CR
MOXLEY, JIMMY /LESLIE
9877 DOTSON ST SE
MECH 29,50CR
TENDERED: 88,50 CHECK
APPLIED: 88,50-
CHANGE: 0.00
JUL /20/2015/MON 12:46 PM Sunset Air FAX No.360 456 4990 P,004/004
CITY OF YELM
�] RESIDEENr,TIAL BUILDING PERMIT APPLICATION FORM
Project Address: `-t 1 1 '1 V LJU 11 � bE Parcel #:
Subdivision:
Lot #: Plan #: Zoning:
❑ New Construction 0 Re -Model J Re -Roof / Addition D Home Occupation Sign
❑ Plumbing [?Mechanical ❑~ Mobile 11Manufacttured Home Placement 0 Other
Project Description /Scope of WorkI
Project Value: 630 o
Building Area (sq. ft) 16 Ploor 2nd Floor 3rd Floor Garage -2 car 3 car
Covered Patio Covered Porch Patio Deck
# Bedrooms— # Bathrooms— Heating: GASIOTHER or ELECTRIC (Circle One)
Are there any environmentally sensitive areas located on the parcel?
If yes, a completed environmental checklist must accompany permit application.
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LICENSE #
ADDRESS EMAIL
CITY STATE —ZIP TELEPHONE
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ADDRESS
• DATE CITY LICENSE#
TELEPHONP
ADDRESS _EMAIL
CITY STATE; ZIP FAX
CONTRACTOR'S LICENSE # EXP DATE CITY LICENSE #�
Copy of mitigation agreement with Yelm Community Schools, if applicable.
- - "_" T herebyceftify- fhaftfie 6Fioe Tformafion is cofrec and -that the construaion on, and t e occ fancy and -the use oFfhe
above d scribed property will be in accordance with the laws, rules and regulations of the State of Washington and the
Clty e1
Applica is Signature Date
Owner 1 Contractor / Owner's Agent I Contractor's Agent (Please circle one.)
All permits are nontransferable and will expire if work authorized by such permit Is not begun
within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days
JUL 9,G
.105 Yalm Avenue 'Guest
Yelm, WA 98597
www.ci,yeim.rua. us
(360) 458 -3835
(360) 458 -3)d4f FAX
JUL /20/2015/MON 12;45 PM Sunset Air FAX No,360 456 4990 P.001 /004
SUNSET AIR, INC
PHONE: (360) 456 -4956 FAX: (360) 456 -4990
5210 LACEY BLVD. LACEY, WA 98503
FAX TRANSMISSION
TO:
DATE /TIME: 7'd-fl/l 'J
COMPANY: bt
FAX #: 'JC�(�- �{^ 31 L 1
FROM; ROMY MEYER - RTM@5UN5ETAIR.CQM
COMMENTS:
Pit fy�E-L- QPV� LACb R
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This transmission contains pages, including this cover page. If any page is
missing, please contact me at the above number,
JUL 2 0 2015